Infertility, a problem with a solution - Dr. Carlos Zorro, gynecologist in Bogota

According to the World Health Organization, a couple is considered infertile if they have had over 1 year of unprotected sexual intercourse without achieving pregnancy. If a woman is over 35 years old and has only 6 months of trying without success, infertility is also considered, and she should seek specialized help.

It is important to consult a gynecologist specialized in human reproduction to evaluate possible causes of infertility and consider suitable treatments. Some conditions, such as polycystic ovary syndrome, endometriosis, or previous gynecological surgeries, require earlier consultation. Age is also critical; women over 35 should receive special consideration and expedited testing.

The most common fertility treatments include ovulation induction, intrauterine insemination (IUI), in vitro fertilization (IVF), and egg donation.

Aerobic exercise of 3 to 5 hours per week has been associated with higher chances of pregnancy and can even increase the success rate of fertility treatments.

It is recommended to avoid fast foods high in calories, refined flours, sugars, and fatty foods, as they increase free radicals and oxidative stress, interfering with hormonal function, ovulation, and fertility. Drinking more than two cups of coffee a day has also been linked to reduced fertility and higher miscarriage risk.

A preconception consultation is recommended to detect potential risk factors for infertility. If results are normal, another consultation is advised after 6 months of unsuccessful attempts to evaluate the need for a more in-depth assessment with a human reproduction specialist.

The only necessary supplement is folic acid (400 µg/day), which reduces the risk of neural tube defects in the baby. The effectiveness of other supplements has not been demonstrated universally.

There is no ideal frequency, but having intercourse two to three times a week is usually sufficient. In some cases, focusing on the fertile period as directed by your gynecologist can improve the chances of pregnancy.

Fertile days vary among women. They can only be estimated with regular cycles of 21 to 35 days. Typically, fertile days fall between day 10 and day 14 or 15 of the cycle. Using fertility apps or consulting a doctor or human reproduction specialist is recommended for more accurate calculation.

Conditions affecting the uterus, fallopian tubes, or ovaries are commonly associated with infertility. Examples include polycystic ovary syndrome, endometriosis, pelvic inflammatory disease, fibroids, endometrial polyps, adenomyosis, uterine malformations, and previous gynecological surgeries.

Excessive coffee consumption (more than two or three cups per day) has been associated with fertility problems, miscarriages, and intrauterine growth restriction.

Infertility can be caused by gynecological conditions affecting the fallopian tubes, ovulation, or uterus (e.g., endometriosis, polycystic ovary syndrome, thyroid problems, fibroids), excessive or insufficient weight, smoking, and unhealthy lifestyle habits. Male factors also contribute to infertility in 50% of cases.

There is no single test that determines fertility. Basic tests include transvaginal ultrasound to assess ovarian reserve and uterus, hysterosalpingography to check the fallopian tubes, progesterone levels to evaluate ovulation, and semen analysis to assess male fertility.

The best recommendations are to maintain a healthy lifestyle with balanced diet and exercise, maintain healthy weight, avoid smoking, and seek timely consultation with a specialist, since age is the main factor affecting fertility.